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Neighborhood Care

EmblemHealth VIP Dual Reserve (HMO D-SNP)

This is a special needs plan (HMO D-SNP) for people enrolled in Medicare and who have full New York State Medicaid. Since you have Medicaid, you qualify for Extra Help and pay $0 each month for this plan. You pay $0 for covered services in this plan.

You will also get benefits Medicare does not cover, like preventive and comprehensive dental, hearing aid allowance, eyewear allowance, and $80 monthly for over-the-counter (OTC) items.

 

Available in the following counties: Bronx, Kings, New York, and Queens

 

Provider Network: VIP Reserve

Plan Option Premium
EmblemHealth VIP Dual Reserve $0.00

Quick Links

Plan Highlights

If you have questions, please call 800-859-4880 (TTY: 711). From Oct. 1 to March 31, you can call us from 8 a.m. to 8 p.m., seven days a week. From April 1 to Sept. 30, you can call us from 8 a.m. to 8 p.m., Monday through Friday. 

Benefit Summary

Type of Care Copay
Primary care doctor visit: $0
Specialist doctor visit: $0
Preventive care: $0
Urgently needed services: $0
Emergency room: $0
Inpatient hospital coverage: $0
Lab services: $0
Type of Care Copay
Foot care: $0
Dental services: Preventive and Comprehensive
Hearing aids: Up to $3,000 every 3 years
Routine eyewear: Up to $350 every year
24-hour Nurse Line: Yes
SilverSneakers®: Yes
Prescription drug: Yes

Drug Coverage

Having the prescription drugs you need is an important part of staying healthy, which is why we take our pharmacy offerings very seriously. We strive to help you make sure you can afford the prescription drugs you take. Our formulary gives you access to thousands of them, and our pharmacy network is large enough to provide the choices you need—close to home.

     Initial Coverage
$0-$2,100 – 30-Day Supply 
 Catastrophic Coverage
Annual Deductible

$0

$0

Generic Drugs

$0 or $1.60 or $5.10

Depends on your level of extra help

Brand Drugs

$0 or $ 4.90 or $12.65

Depends on your level of extra help

$0 for most adult Part D vaccines, including shingles, and some travel vaccines.

Set up Home Delivery and Refills for Prescription Drugs

Have your prescriptions and refills delivered directly to your home through Amazon Pharmacy or Express Scripts, Inc., our preferred mail-order pharmacy.

 

Plan Documents

  • Summary of Plan Benefits

  • Evidence of Coverage

    Coming Soon
  • LIS Plan Summary

  • EmblemHealth Medicare Star Ratings

    Coming Soon

  • Preventive and Comprehensive Dental Benefits

  • Annual Notice of Changes

Medicare HMO Provider & Pharmacy Directories

Health Insurance Plan of Greater New York (HIP) is an HMO/HMO-POS plan with a Medicare contract and an HMO D-SNP plan with a Medicare contract and a contract with the New York State Department of Health. Enrollment in HIP depends on contract renewal. HIP is an EmblemHealth company. 

SilverSneakers is a registered trademark of Tivity Health, Inc. © 2025 Tivity Health, Inc. All rights reserved.

Teladoc and related marks are trademarks of Teladoc Health, Inc. and are used by EmblemHealth with permission.

Because you qualify for extra help, you get reduced Part D cost-sharing benefits when you enroll.

Last Update 10/01/2025

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VIP Dual Reserve (HMO D-SNP)

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